Published in Medicinewise Living
Date published: About this date
Treatment can depend on the cause of pain but usually includes rest, stretches and pain relief.Image: Rachel Brunette / www.shutterstock.com
Heel pain is a common foot problem, particularly for runners and joggers. The pain often resolves by itself, but a combination of treatments can help along the way.
How does heel pain develop?
Heel pain is often due to a damaged plantar fascia — the band of tissue connecting your heel to other parts of your foot. Other causes of heel pain include stress fractures, inflammation of a bursa (fluid-filled sac between muscles, tendons and bones), and nerve or joint problems in your feet.
Running or jumping on hard surfaces can damage the plantar fascia. The risk also increases if you:
- are overweight
- are aged 40 to 60
- have flat feet or walk in an abnormal way
- usually wear poorly-fitting, flat or high-heeled shoes
- stand or walk for long periods in your job.
What are the symptoms?
Heel pain may involve one or both feet and can worsen over time. A severe sharp pain or dull ache is usually felt on the bottom of the foot, rather than the back of the heel.
The pain is generally more intense in the morning or when you first step on your heel after resting it. The pain often subsides as you walk but can worsen again after a long time walking or standing.
What are the potential complications?
Injuries to the plantar fascia can eventually form a bony growth called a heel spur. Inflammation in the area may cause pain.
Trying not to step on a painful heel may cause some people to develop a limp or abnormal way of walking. This may contribute to further problems with your feet, knees, hip or back.
How can I treat heel pain?
Treatment can depend on the cause of pain but usually includes rest, stretches and pain relief.
A doctor or podiatrist may advise new footwear, shoe inserts, strapping or night splints. Surgery is sometimes necessary.
Resting the foot
Avoid standing for too long or doing exercise that worsens your pain (e.g. walking or running for long periods of time). Instead, try activities that place less weight on the feet (e.g. swimming or cycling).
Regular stretching can help relieve heel pain and improve foot flexibility. A doctor or physiotherapist may advise on specific stretches.
Get advice about pain relief from a doctor or pharmacist. Treatment can depend on whether inflammation is involved.
A simple pain relief medicine (such as paracetamol or ibuprofen), ice packs, or heat treatments may help.
A corticosteroid medicine may be injected into the plantar fascia if other treatments don’t reduce pain.
Some pain relief medicines are not suitable for some people, including those with high blood pressure, liver or kidney problems.
How can I prevent heel pain?
To help support your feet and prevent further heel pain:
- wear appropriate footwear, or shoe inserts
- replace sports shoes regularly
- lose weight if you are overweight
- warm up and stretch after exercise
- do strength and flexibility exercises routinely.
When should I see a health professional?
A doctor or podiatrist can often diagnose the cause of heel pain by checking your symptoms and examining your foot. Further tests may be needed if your pain is not related to inflammation.
Watch your cortisone shots
Having too many corticosteroid injections can be harmful.
Repeated injections can weaken or rupture soft tissues (including the plantar fascia), destroy cartilage in joints, or cause death of bone near the injection area. Limit your shots to help prevent these complications. Generally, no more than four corticosteroid injections a year are recommended.
Your doctor may advise against any further injections if there has been no improvement after two consecutive injections.